Methods and systems for dental procedures

ABSTRACT

A device including a coded pattern for use in dental procedures is provided. Related methods and systems are also provided.

CROSS-REFERENCE

This application is a divisional application of U.S. application Ser.No. 13/787,634, filed Mar. 6, 2013, now U.S. Pat. No. 9,668,829, issuedJun. 6, 2017, which claims the benefit of U.S. Provisional ApplicationNo. 61/739,450, filed Dec. 19, 2012, each of which are incorporatedherein by reference in their entirety.

BACKGROUND OF THE INVENTION

Articulators are well known dental devices which attempt to replicatethe movement of the lower jaw relative to the upper jaw about theTemporomandibular Joint (TMJ) in a patient-specific manner Plastermodels of the patient's upper and lower teeth arches can be mounted tothe articulator with respect to its hinge axis in a manner simulatingthat of the real teeth arches with respect to the patient's TMJ joint.Traditionally, physical impressions of the dental arches are provided,which are then used for casting the plaster models. In addition, a biteimpression is obtained with a wax bite plate, which records the relativepositions of the upper and lower arches.

A mechanical facebow with a bite fork can be used for obtainingpatient-specific measurements which are then used to set up the plastermodel in a particular articulator. In particular, the spatialorientation of the patient's maxillary arch with respect to the earcanals is duplicated by the facebow. The facebow is engaged to the earcanals via an ear canal insertion portion. Then, a bite fork withimpression material is brought into engagement with the maxillary teeth,and a jig connects the bite fork via its arm to the facebow. The facebowand bite fork combination are then mechanically rigidly coupled to thearticulator, such that the ear canal insertion portions are in thecorresponding alignment with the pivot axis of the articulator. Theplaster models are mounted to the articulator so as to engage and thusmatch the position of the bite fork, and plaster filling is providedbetween each plaster model and the respective articulator alai. This isa complicated and time consuming process, and which requires experthandling.

While facebows can be used to facilitate determining thepatient-specific measurements needed to accurately place physical modelsof the patient's teeth into an articulator, there is a need foradditional advancements. For example, methods, devices and systems areneeded that can increase the speed of acquiring the patient specificmeasurements during a visit to a dental practitioner and/or provide moreaccurate measurements for use in mounting physical models to anarticulator.

SUMMARY OF THE INVENTION

The present invention provides systems, methods and devices having acoded pattern for use in dental procedures. In an example, the presentinvention provides a device including a coded pattern that can, e.g., beused to improve scanning time and accuracy for generating digital datausing in dental procedures.

In some aspects, the present invention provides a device for use indental scanning procedures of a patient. The device can include anocclusal portion and a non-occlusal portion, the occlusal portioncomprising a bite plate for securing the device positioned in apatient's mouth during a scanning procedure and the non-occlusal portioncomprising a coded pattern for aligning scanned images of the patient,the occlusal portion and the non-occlusal portion being coupled togetherat an angle such that the coded pattern is outwardly oriented from thepatient's mouth when the bite plate is positioned between the patient'steeth, so that the coded pattern is presented to permit scanning of thecoded pattern simultaneously when scanning at least some of thepatient's teeth. Related methods and systems are also provided.

For a fuller understanding of the nature and advantages of the presentinvention, reference should be made to the ensuing detailed descriptionand accompanying drawings. Other aspects, objects and advantages of theinvention will be apparent from the drawings and detailed descriptionthat follows.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 depicts a system including a device having a coded pattern, inaccordance with an embodiment of the present invention.

FIG. 2 shows an example method for determining a spatial relationshipbetween a patient's teeth and a reference, in accordance with anembodiment of the present invention.

FIG. 3 shows an example method for determining a spatial relationshipbetween a patient's teeth and a reference, in accordance with anembodiment of the present invention.

FIGS. 4A-C depicts steps in a method for determining a spatialrelationship between a patient's teeth and a reference, in accordancewith an embodiment of the present invention. FIG. 4A shows positioningof a device in front of a patient's face. FIG. 4B shows aligning thedevice with a patient's sagittal plane. FIG. 4C shows scanning the codedpattern of the device and at least a portion of the patient's teeth.

FIG. 5 illustrates a patient wearing a device including a coded pattern,in accordance with an embodiment of the present invention.

FIG. 6A shows a front view of physical models of a lower and upper archof a patient's teeth, and FIG. 6B shows the physical models each mountedon a respective base and couplable to an articulator, in accordance withan embodiment of the present invention.

FIG. 7 shows an example device having a coded pattern in relation toteeth, in accordance with an embodiment of the present invention.

FIG. 8A illustrates a head-on view of a patient in relation to a devicehaving a coded pattern and FIG. 8B illustrates a profile view of thedevice having a lip displacement attachment, in accordance with anembodiment of the present invention.

FIG. 9 provides example scan data acquired of a patient's teeth inrelation to a device having a coded pattern, in accordance with anembodiment of the present invention.

FIGS. 10A-D illustrate examples of coded patterns, in accordance withsome embodiments of the present invention.

FIG. 11 shows a lengthwise portion of a coded pattern shaped to providea reference line, in accordance with an embodiment of the presentinvention.

DETAILED DESCRIPTION OF THE INVENTION

The present invention provides a device having a coded pattern for usein dental procedures. In an example, the present invention provides adevice including a coded pattern that can, e.g., be used to improvescanning time and accuracy for generating digital data using in dentalprocedures. Related methods and systems are also provided.

As will be described herein, one aspect of the present inventionincludes using the devices described herein to generate physical modelsof a patient's teeth for mounting in an articulator and in anarrangement that accurately represents the relative positions of all ora portion of a patient's upper and lower arch. Accurate representationsof positions of the patient's teeth can be facilitated by determining aspatial relationship between the patient's teeth and a reference, e.g.,a reference point on the patient, such as the sagittal plane of thepatient's face. In some aspects, the present invention provides deviceshaving a coded pattern that improves capabilities for quickly andaccurately determining spatial relationships that are used to produceaccurate placement of physical models in an articulator. As will bedescribed herein, the coded pattern, for example, can be designed toallow for easier and more efficient alignment of scan images taken ofthe patient and the device having the coded pattern.

The present invention includes scanning systems that can be used for avariety of procedures, such as scanning a patient's teeth, scanningdevices worn by a patient, and/or scanning a patient wearing a devicehaving a coded pattern. In one aspect, the present invention includes asystem for digitally aligning a patient's teeth with a reference portionof the patient. The system can include a device comprising an occlusalportion and a non-occlusal portion, the occlusal portion comprising abite plate for securing the device positioned in a patient's mouthduring a scanning procedure and the non-occlusal portion comprising acoded pattern for aligning scanned images of the patient, the occlusalportion and the non-occlusal portion being coupled together at an anglesuch that the coded pattern is outwardly oriented from the patient'smouth when the bite plate is positioned between the patient's teeth, sothat the coded pattern is presented to permit scanning of the codedpattern simultaneously when scanning at least a portion of the patient'steeth, the device further comprising at least one extension portioncapable of being aligned with the reference portion. The system can alsoinclude a scanner for acquiring a first image of at least the portion ofthe patient's teeth and a second image of the coded pattern and at leastthe portion of the patient's teeth; and a computer comprising storagemedia comprising instructions that, when executed, cause the computer todetermine a spatial relationship between at least some of the patient'steeth and the reference portion associated with the patient bycalculating a first spatial relationship between the device and at leastthe portion of the patient's teeth and a second spatial relationshipbetween the device and the reference portion.

Referring to FIG. 1, a scanning system 100 of the present invention caninclude a computer system 102 having a computer 104 and a display 106.The system 100 can also include a scanner 108 that can be used to scan apatient 110 and a device having a coded pattern 112. The scans can beused, e.g., to generate three dimensional (3D) digital models 114 of thecoded pattern and at least a portion of the patient's teeth. Thecomputer system 100 can include a microprocessor, memory, or any othersuitable hardware configured to process a scanned image of the patientand the device having the coded pattern. The computer system 100 canalso include input modules such as a keyboard, mouse, tablet, and so on.The display 106 (or output device) can include a screen or monitor butmay also include a printer, or any other display system. The display ofthe system, e.g., can be used to show the generated 3D digital models(e.g., of the coded pattern).

A variety of scanners can be used in the present invention, e.g., toacquire scan images of a device having a coded pattern in relation to apatient's teeth. The scanner 108, for example, can be configured toacquire surface topology of structures, in particular dental surfaces ofdental structures and/or other tissue surfaces of the face and head of apatient. In one embodiment, the scanner 108 can be used to acquire scanimage data for 3D digital models 114 of the device having the codedpattern along with at least a portion of the patient's teeth. As shownin FIG. 1, the scanner 108 is also operatively connected to the computersystem 102. The computing system 102 is suitably programmed forreconstructing scanned surfaces from the surface data provided, toprovide a corresponding digital model of the structure scanned by thescanner. The scanner 108 may also include, for example, any suitablenon-contact scanner, for example an optical scanner. By way ofnon-limiting example, the scanner 108 may include a probe fordetermining a three dimensional (3D) structure by confocal focusing ofan array of light beams, for example, as disclosed in WO 00/08415, thecontents of which are incorporated herein in their entirety.Alternatively, the required scanning may be accomplished using any othersuitable scanning apparatus, for example comprising a hand held probe.

In some embodiments, the present invention includes acquiring colorimage data of the intraoral cavity that can be provided together withthe scan image data to provide a digital model that includes 3D digitaldata representing the surfaces of the structures as well as colorinformation of the structures scanned, such as for example of dentalsurfaces. Examples of such scanners are disclosed in, for example, US2006/0001739, which is incorporated herein by reference in its entirety.

The scanning systems of the present invention can also be used forgenerating 3D digital models of all or a portion of an intraoral cavity.In some embodiments, the system can also be configured to scan andgenerate 3D digital models of the upper and/or lower arch of thepatient. In certain embodiments, the system can be configured to scanand generate 3D digital models of the upper and lower arches together inocclusion. As described further herein, the 3D digital models can beused for certain aspects of the methods of the present invention. Forexample, the 3D digital models can be used in alignment proceduresand/or for generating physical models that accurately represent actualpositions of the patient's teeth when the models are mounted in anarticulator. The 3D digital models can include topographical datarepresenting a variety of dental structures such as one or more teeth,partial or the full mandibular or maxillary arches, or both arches,and/or details of the spatial relationship between the upper and lowerarches in occlusion as well as surrounding tissue, such as gums, andother dental prosthetics (e.g., crowns).

The 3D digital models can be acquired using a variety of suitablemethods. In one embodiment, 3D digital models can be obtained byscanning a patient's intraoral cavity using any suitable equipment forscanning a patient's teeth. Such scanning equipment may include anysuitable optical scanner, for example, the scanner 108 of system 100, asimilar scanner that is not part of the system 100, or a different typeof scanner. In alternative embodiment, the 3D digital models can beobtained from a physical model of the teeth of the particular patient.For example, the surfaces of the physical model can be scanned, or thesurfaces of the impression from which the model was scanned can bescanned to obtain the digital model. In some embodiments, scans can betaken of physical models of a patient's lower arch, upper arch, and thearches in occlusion. Together with a scan of the coded pattern at leasta portion of the patient's teeth, the physical models can then bemodified, e.g., with alignment structures that provide for accuraterepresentation of the patient's occlusion when the models are mounted inan articulator (e.g. holes in the models can have predetermined shapes,sizes and/or orientations for accurate mounting in an articulator). Insome embodiments, a composite positive-negative model can bemanufactured and processed to obtain 3D digitized data, for example asdisclosed in U.S. Pat. No. 6,099,314, the content of which isincorporated herein in its entirety. Alternatively, the 3D digitizeddata may be obtained in any other suitable manner, including othersuitable intra oral scanning techniques, based on optical methods,direct contact methods or any other means, applied directly to thepatient's dentition or to a physical model thereof. X-ray based, CTbased, MRI based, or any other type of scanning of the patient or of apositive and/or negative physical model of the intra-oral cavity can beused, as well. 3D digital models can also be obtained by other ways,such as from an electronic record or another practitioner or scanningfacility.

The present invention further includes methods for scanning a patient'steeth to determine a spatial relationship between the teeth and areference. In one aspect, the present invention includes a method fordigitally aligning a patient's teeth with a reference portion of thepatient. The method can include acquiring, using a scanner, a firstimage of at least a portion of the patient's teeth. The method can alsoinclude positioning a device in a patient's mouth to align the devicewith a reference portion of the patient, the device comprising anocclusal portion and a non-occlusal portion, the occlusal portioncomprising a bite plate held between the patient's teeth so as to securethe device in a position during a scanning procedure and thenon-occlusal portion comprising a coded pattern for aligning scannedimages of the patient, the occlusal portion and the non-occlusal portionbeing coupled together at an angle such that the coded pattern isoutwardly oriented from the patient's mouth when the bite plate ispositioned between the patient's teeth, so that the coded pattern ispresented to permit scanning of the coded pattern simultaneously whenscanning at least the portion of the patient's teeth. The methods caninclude acquiring, using the scanner, a second image of at least aportion of the coded pattern and at least the portion of the patient'steeth; and processing the first image and the second image to determinea spatial relationship between at least the portion of the patient'steeth and the reference portion by calculating a first spatialrelationship between at least the portion of the coded pattern and atleast the portion of the patient's teeth and the alignment between thedevice and the reference portion.

FIG. 2 shows an example method 200 of the present invention. In Step202, a device disclosed herein is positioned in a patient's mouth. InStep 204, a scan is acquired of the device and the teeth. A scan of thedevice and a reference is also acquired. In Step 206, the methodincludes determining a spatial relationship between the teeth and thereference. In some embodiments, the methods can further include Step208, generating and/or modifying 3D digital models of the patient'steeth based on the determined spatial relationship between the teeth andthe reference. In certain embodiments, the method can also include Step210, outputting and/or using the 3D digital models and the determinedspatial relationship data to fabricate physical models of the patient'steeth.

FIG. 3 shows another example method 300 of the present invention. InStep 302, a scan can be acquired of at least a portion of the patient'supper and/or lower arches. In some embodiments, a full scan of the upperand lower arch can be acquired and used for fabricating physical models.The arches can include regions for installing a prosthodontic dentalappliance, e.g., a crown and/or a bridge. In Step 304, a scan can beacquired of at least a portion of the patient's upper and/or lowerarches in occlusion. Scan image data acquired at this step can be used,e.g., for determining how to fabricate the physical models such thatthey can be mounted in an articulator in proper occlusion, e.g., withoutany additional manipulation of the models to achieve accurate and properpatient occlusion. In Step 306, a scan can be acquired of a devicehaving a coded pattern and at least a portion of the patient's teeth. Insome embodiments, the device can also include extension portions orother structures that can align with a reference (e.g., a facial featureon the patient, such as the sagittal plane). A scan of the device canalso include scanning the extension portion. In Step 308, a spatialrelationship between at least a portion of the patient's teeth and thereference can be determined. For example, the scan image data of theupper and lower arch in occlusion can be matched with the scan imagedata of the device and at least a portion of the patient's teeth todetermine how the patient's occlusion is spatially oriented in relationto the reference, e.g., the sagittal plane. Alternatively, the scanimage data of the device and at least a portion of the patient's teethcan be compared (e.g., matched) with other scan image data acquired ofthe patient's upper and/or lower arches. Based on these steps, data canbe produced that can be output to a fabrication machine for fabricatingphysical models of the patient's teeth. In some embodiments, thephysical models can include alignment structures (e.g., holes formounting on an articulator) that have a location, shape, size andorientation on the physical model so as to place the upper and lowerarch in proper and accurate occlusion upon mounting to the articulator.In certain embodiments, the method can also include Step 310, outputtingand/or using the 3D digital models and the determined spatialrelationship data to fabricate physical models of the patient's teeth.

In addition to other methods described herein, the determination ofspatial relationships can be conducted in a variety of ways. In oneaspect of the present invention, scan image data can be acquired tofacilitate determination of a spatial relationship between a referenceand a device having a coded pattern. For example, a spatial relationshipbetween all or a portion of a patient's maxillary arch and a hinge axisof the jaw of a patient can be determined and then used for constructingphysical models of the tooth arches that engage with a dentalarticulator in a spatial relationship with the articulator hinge axisthat parallels the corresponding relationship in the patient.

In some embodiments, an accurate representation of a spatialrelationship between a patient's arch and the jaw hinge axis can bedetermined, for example, by scanning at least one zone that canseparately include all or a portion of a device having a coded pattern,at least one of the patient's teeth, and, in some embodiments, areference, e.g., a reference of the patient. The number of zones scannedcan depend on various factors, such as the desired accuracy and/or timeconsiderations. In some instances, scanning of more zones may improveaccuracy with a possible tradeoff of increased processing times.

In certain embodiments, one zone can be scanned and used to determine aspatial relationship that can be used to, e.g., produce physical modelsfor mounting in an articulator, accurately representing a patient'socclusion. In one example, a scan zone can include at least a portion ofa coded pattern and at least a portion of the patient's teeth (e.g.,several teeth). As described further herein, the coded pattern caninclude structures and/or registration marks that allow determination ofwhat part of the coded pattern is scanned. Data stored on the system orprovided from elsewhere can be used to then identify where the scannedzone is in relation to a reference of the patient. In some embodiments,for example, the reference of the patient can be the sagittal plane ofthe patient. In such an embodiment, the device including the codedpattern can also include an extension portion that aligns with thepatient's sagittal plane. Other facial features of the patient can alsobe used for alignment and scanning. For example, the device can alsoinclude a horizontal extension portion that is orthogonal to thepatient's sagittal plane. Other facial features can include, forexample, the TMJ, a mark placed on the patient's face, the patient'schin, nose, and/or eyes.

FIGS. 4A-4C provides an example embodiment using a scan of one zone todetermine how a patient's upper and/or lower arch are positioned inspace compared to a reference on the patient, e.g., the sagittal plane.As shown in FIG. 4A, a device having a coded pattern 400 and vertical402 and horizontal 404 extension portions can be positioned in relationto a patient's face 406. FIG. 4B illustrates alignment of the devicewith the patient's sagittal plane 408 and positioning the coded patternin front of the patient's teeth 410. FIG. 4C depicts a scanner 412 forscanning one zone including the coded pattern of the device 400 alongwith at least a portion of the patient's teeth 410. As described furtherherein, the scan image data acquired from the scan can be used for avariety of purposes, such as fabricating physical models of thepatient's teeth for mounting in an articulator.

In some embodiments, two zones can be scanned and used to determine aspatial relationship. Alternatively, three or more zones can be scanned.FIG. 5 provides a representation of a scanning procedure 500 used todetermine a spatial relationship between at least some of the patient'steeth and the patient's TMJ. As shown, a nonocclusal portion including acoded pattern 502 can be presented to permit scanning of the codedpattern simultaneously when scanning at least some of the patient'steeth. The coded pattern 502 can also be integrated with an extensionportion 504 integrated with a facebow structure 506 as well as anocclusal portion of the device (not shown), which can be placed in thepatient's mouth. The spatial orientation of the occlusal portion and thenonocclusal portion including the coded pattern can be fixed such thatthe device is rigidly held in relation to the patient during scanning.In an example sequence, Zone 1 (508) can be scanned using a scanner toacquire scan image data of at least some of the patient's teeth, atleast a portion of the coded pattern and an extension portion 504 of thefacebow structure 506. A digital model of Zone 1 can be generated andcan include at least some of the patient's teeth 510, at least a portionof the coded pattern 502, and/or the extension portion 504. The relativeposition of a reference point on the patient, e.g., the ear canal axis512 with respect to the extension portion 504 is known. Thus, thedigital model of the patient's teeth 510, the coded pattern 502 and theextrusion portion 504 can then be registered with the position andorientation of the ear canal axis 512, which is a body reference ofinterest. The ear canal axis can be represented digitally, as well, andthen be positioned with respect to the digital model of the patient'steeth in a common coordinate system.

In an alternative embodiment, another scan may be acquired of a Zone 2(514) including markers 516, such that the position and orientation ofthe markers with respect to the extension portion 504 may be determined.In this instance, the position and orientation of the patient's TMJ,which can also be a reference point of interest, can be determined withrespect to the digital model of the patient's teeth in a commoncoordinate system. In addition to the ear canal axis and the TMJ, thereare several other possible reference points can be used for determiningspatial relationships. For example, other reference points include, butare not limited to, the sagittal plane of the patient, an anatomicalfeature on the patient, or a marked feature on the patient (e.g., aninked marking).

In yet another embodiment, two zones can be scanned and used todetermine the spatial relationship between at least some of thepatient's teeth and a reference, e.g., an ear canal axis of the patient.In an example sequence, a first zone can be scanned using a scanner toacquire scan image data of at least some of the patient's teeth and atleast a portion of the coded pattern. A digital model of the first zonecan be generated and can include at least some of the patient's teethand at least a portion of the coded pattern. A second zone can bescanned, which includes a portion of the coded pattern and a section ofan extension portion. Zone 2 also includes a portion of an extensionportion that is aligned or otherwise spatially oriented with a referencepoint of the patient. A digital model of the second zone can begenerated and can include at least a portion of the coded pattern andthe extension portion. Since the geometry of the coded pattern and thedevice is known, it is then possible to place the digital models of thefirst zone and the second zone in the same coordinate system. Forexample, the portion of the coded pattern that is scanned in the firstzone and the second zone can be aligned digitally. The relative positionof a reference point on the patient, e.g., the ear canal axis withrespect to the extension portion is also known. Thus, the digital modelof the patient's teeth including the coded pattern can then beregistered with respect to a reference, e.g., the ear canal axis. Theposition and orientation of the ear canal can be determined with respectto the digital model of the patient's teeth in a common coordinatesystem.

The spatial relationship between at least a portion of the patient'steeth and a reference on the patient (e.g., the sagittal plane of thepatient) can be determined by several different methods. For example,software modules can be used on the system to process scan image data soas to calculate dimensions and orientations of, e.g., the patient'supper and/or lower arch, the device having a coded pattern and/orextension portion, and the reference on the patient. In someembodiments, determination of the spatial relationship among variouscomponents can be performed digitally. For example, scan image data caninclude 3D digital models of the device having the coded pattern and anextension portion that has been acquired in alignment with a referenceof the patient (e.g., the sagittal plane of the patient). The 3D digitalmodel can further include scan image data of at least a portion of thepatient's teeth. Additional 3D digital models can also be provided ofthe patient's upper arch and/or the lower arch, as well as the patient'supper and lower arches in occlusion. In some embodiments, the 3D digitalmodels of the patient's upper and/or lower arches can be visuallyaligned with the 3D digital model of the device having the coded patternand at least a portion of the patient's teeth. For instance, the 3Ddigital model of the coded pattern can include at least a portion of thepatient's incisors and canines in the upper arch. These teeth can thenbe visually overlaid with the same corresponding teeth in the 3D digitalmodel of the patient's upper arch scan data. Alternatively, matchingalgorithms or other ways to overlay the digital models can be used foralignment. Given that the coded pattern data was obtained in alignmentwith, e.g., the sagittal plane of the patient, the scan image data ofthe upper arch can then be aligned with the sagittal plane. Thisalignment information can be used to generate a physical model in adigital form that can be used to ultimately make a physical model in aphysical form. In some embodiments, the physical models in digital formcan be mounted on an articulator that is also in digital form. In suchan embodiment, alignment structures (e.g., mounting holes or othermarkings) can be added to the digital physical model such that thephysical models (e.g., of the upper and lower arch) mount on thearticulator and fit together in proper occlusion according to theparticular patient. The spatial relationship data determined using themethods and systems herein can also be used to make physical models thatcan be placed in proper occlusion using ways other than mounting in anarticulator. For example, the physical models can be fabricated toinclude alignment structures that can, e.g., clip the upper and lowerarches together, or portions thereof, in proper occlusion correspondingto the patient's actual occlusion.

The accurate information acquired for the spatial relationship of thepatient's teeth and a reference can be used in a variety of dentalprocedures. For example, with a known spatial relationship between atleast some of the patient's teeth and a reference point on the patient(e.g., the sagittal plane), physical models of the patient's teeth canbe positioned within an articulator in an accurate orientation that isconsistent with the patient's actual orientation. There are severalsuitable avenues for accurately positioning one or both physical archmodels in an articulator. FIG. 6A shows a front view of two physicalarch models representing a patient's upper arch 602 and lower arch 604.FIG. 6B shows the two physical arch models 602, 604 of the patient'steeth each mounted on a top base 606 and a bottom base 608 that, forexample, can be coupled to an articulator so as to position the physicalmodels in a relative orientation, e.g., in proper occlusion thatrepresents the patient's occlusion. Using the determined spatialrelationship between at least some of the patient's teeth and areference point on the patient, a technician or other dentalpractitioner can accurately mount the physical models in thearticulator. In some embodiments, the base of the physical model can bemolded or fabricated so as to have a particular structure that orientsthe physical model in the correct position when it is placed in thearticulator. Alternatively, the components of the articulator can bepositioned in a manner so as to place a physical model in the correctposition. In one aspect, the present invention includes a physical modelhaving a structure that when mounted in an articulator correctlyrepresents the actual orientation of the patient's arch. In addition,the upper and lower arches can be manufactured to accurately representthe relative positions of the teeth in each arch in occlusion, e.g., anocclusal spatial relationship. It is also noted that in addition todesigning the physical models for mounting in an articulator, thepresent invention further includes providing data for fabricatingphysical models that can be mounted in other types of configurations.

In some embodiments, a physical tooth model can be designed virtually,and subsequently manufactured, for example by CNC machining/millingmethods, other material removal methods, or by rapid prototypingmethods. One or both tooth models can be digitally integrated witharticulator arms and a part of a hinge arrangement, so that the toothmodels can be hingedly attached to one another at the hinge arrangement.In a digital environment, the integral aims can be virtually attached toa digital model of the patient's upper and/or lower arch in anorientation that corresponds to the correct spatial relationship of areference point (e.g., a hinge axis of the patient's jaw or the sagittalplane) to the physical models. In one aspect, the present inventionincludes a digital model representing a structure that when fabricatedand mounted in an articulator correctly represents the actualorientation of the patient's arch. In addition, the upper and lowerarches can be manufactured to accurately represent the relativepositions of the teeth in each arch in occlusion, e.g., an occlusalspatial relationship.

In addition to the systems and methods described herein, the presentinvention further includes devices having a coded pattern. The devicesand coded patterns can be designed in a variety of ways. The device canbe designed to provide sufficient spatial information for defining theposition of the lower and/or upper arch of a patient in relation to areference point on the patient, e.g., the hinge axis of a patient's jaw.In some embodiments, the device having a coded pattern can include amodified facebow that is coupled to the coded pattern. For example,facebows having a variety of configurations generally known in the artcan be fabricated to include a coded pattern, as described furtherherein. In one embodiment, the present invention includes a devicehaving an occlusal portion and a non-occlusal portion. The occlusalportion can include a bite plate or another structure that isstructurally configured to secure the device positioned in a patient'smouth during a scanning procedure. The non-occlusal portion can includea coded pattern that can have a structure designed to facilitatealigning scanned images of the patient. In some embodiments, theocclusal portion and the non-occlusal portion can be coupled together atan angle such that the coded pattern is outwardly oriented from thepatient's mouth when the bite plate is positioned between the patient'steeth. The outward orientation can be spatially arranged such that thecoded pattern is presented to permit scanning of the coded patternsimultaneously when scanning at least some of the patient's teeth.

In one aspect, the present invention includes a device for use in dentalscanning procedures of a patient. The device can include an occlusalportion and a non-occlusal portion, the occlusal portion comprising abite plate for securing the device positioned in a patient's mouthduring a scanning procedure and the non-occlusal portion comprising acoded pattern for aligning scanned images of the patient, the occlusalportion and the non-occlusal portion being coupled together at an anglesuch that the coded pattern is outwardly oriented from the patient'smouth when the bite plate is positioned between the patient's teeth, sothat the coded pattern is presented to permit scanning of the codedpattern simultaneously when scanning at least some of the patient'steeth. The coded patterns of the present invention can includearrangements of structures and/or characteristics of structures that arepredetermined and designed to allow for determining the location of ascan on the coded pattern when only a portion of the coded pattern isscanned. For example, a scan of only a portion of the coded pattern canbe acquired, but the code of the pattern (e.g., specific widths andarrangements of bars in the pattern) includes information that allowsfor a practitioner to determine where on the device, and the codedpattern, the scan was taken. Without a code, the location of the scanmay not be readily obtainable.

FIG. 7 shows an example of a device 700 having a coded pattern 702. Asshown, the device includes an occlusal portion 704 that is placed in thepatient's mouth. The occlusal portion 704, as shown, is oriented at anangle (e.g., substantially perpendicular) to the nonocclusal portion 706that includes the coded pattern 702. As described further herein, thecoded pattern 702 can have a variety of shapes and patterns. Here, thecoded pattern 702 includes an oval-shaped outer ring with radiating barsoriented vertically in the outer ring. The device further includes a lipdisplacement attachment 708 that is integrated (e.g., molded) to theocclusal 704 and nonocclusal portions 706. In this example embodiment,the lip displacement attachment 708 includes a lip engagement featurethat is shaped to move a patient's lips away from the teeth and codedpattern so as to expose at least some of the patient's teeth and allowscanning of the coded pattern in relation at least some of the patient'steeth. The device 700 of FIG. 7 also includes an extension portion 710that can be used to align the device with a reference. For example, theextension portion 710 as shown is designed to be aligned with thesagittal plane of the patient. Additional structures can be includedwith the devices, e.g., FIG. 7 shows a portion of the device thatprovides a handle 712 for a dental practitioner or technician to holdand place the device in a patient's mouth.

FIGS. 8A and 8B depict different views of another embodiment of a devicehaving a coded pattern. As shown in FIG. 8A, the device can include acoded pattern having a rectangular-shaped outer ring with horizontalbars spanning the rectangle as well as vertically oriented barsintersecting the horizontal bars. In addition to the crossing horizontaland vertically-oriented bars, the coded pattern further includes anadditional alignment feature (e.g., a circle) that can be used to helporient the coded pattern with a reference on the patient. For example,the additional alignment feature can be aligned with the patient'sincisors. Also, the alignment feature and the coded pattern can befurther integrated with several extension portions that, e.g., areoriented with a reference on the patient. For example, in FIG. 8A, theextension portions are oriented with the patient's sagittal plane aswell as orthogonally to the patient's sagittal plane. As illustrated inthe profile view of FIG. 8B, the device having the coded pattern can bepositioned on a patient so as to also displace the patient's lips (e.g.,the upper lip) so as to expose at least some of the patient's teeth andallow scanning of the coded pattern in relation at least some of thepatient's teeth.

As described further herein, the present invention includes scanning atleast some of the patient's teeth in space with devices having codedpatterns. The scan image data generated from the scanning can then beused to generate digital data showing the patient's teeth in relation tothe coded pattern. FIG. 9 provides actual scan image data acquired of atleast some of the patient's teeth as well as a portion of the codedpattern. It is noted that scans can include all of the coded pattern orjust a portion. Furthermore, as shown here, additional scan data wasacquired of the occlusal portion bite plate that is shown in theembodiment disclosed in FIG. 7.

The occlusal portion of the device can include a variety of structures.In one embodiment, the occlusal portion can be a bite plate for securingthe device positioned in a patient's mouth during a scanning procedure.The bite plate can, e.g., include a material that can be used to take abite impression of a patient, thereby making the bite plate specific fora particular patient. Alternatively, the bite plate may be standardshape that does not specifically conform to a patient's teeth. Othersuitable structures for securing the device in the patient's mouth canbe used.

The occlusal portion and the nonocclusal portion of the device can becoupled together. For example, the occlusal portion and the nonocclusalportion can be coupled together at an angle, such that, e.g., a planarsurface of the occlusal portion is substantially orthogonal to a planarsurface of the nonocclusal portion. Other angles can be used, e.g., 45degrees or 60 degrees. In one embodiment, the occlusal portion and thenon-occlusal portion can also be coupled together at an angle that isadjustable around an axis formed by the coupling of the occlusal portionand the non-occlusal portion. For example, the axis can be formed at theintersection between a planar surface of the occlusal portion and aplanar surface of the nonocclusal portion.

A variety of patterns can be used for the coded patterns on the devicesof the present invention. In some aspects, the coded pattern includesstructures that have predetermined shapes and/or dimensions selected toallow for scanning of the coded pattern such that data from at least onescan can be used to determine the position of the scan can be determinedin relation to at least the entire coded pattern, and in someembodiments the entire device. For example, the coded patterns caninclude varied widths, heights, shapes, sizes, orientations, markings,and/or arrangements with other structures that can be designed to allowfor determination of a location in the coded pattern only if a smallportion of the pattern is scanned.

In some embodiments, the coded pattern can include a plurality of barsoriented in the coded pattern at predetermined distances from eachother, intersecting at predetermined angles, or both. The coded patterncan include horizontal bars intersected vertically oriented barsdisposed at different angles with respect to the horizontal bars. Incertain embodiments, the coded pattern can include bars oriented in aradial pattern. Furthermore, the bars of the coded pattern can beintegrated with an outer structure, such as an oval, circle, square,rectangle or some other geometrical structure. The outer structure canbe closed or open.

FIGS. 10A-D show just a few example coded patterns that can be used. Forexample, FIG. 10A shows an oval-shaped outer ring with intersectingcrosshatch bars. Alternatively, FIG. 10B shows a honeycomb patternwithin a rectangular outer ring. FIG. 10C depicts a patter similar tothat shown in FIG. 7 in which a rounded rectangular-shaped outer ring isintegrated with horizontal, parallel bars intersecting verticallyoriented bars. FIG. 10D shows an oval-shaped outer ring with radiallyoriented bars.

To further assist in aligning the coded pattern with structures inanother image, the devices disclosed herein can further include aportion of the device that defines additional reference features forfacilitating alignment. For example, a coded pattern can include alengthwise portion forming a reference line for aligning images acquiredduring the scanning procedure. FIG. 11 shows an example of thisembodiment. As shown, all or a portion of the coded pattern or anothersection of the device can be formed to have a shape that generates aridge feature that can provide a reference line along the length of theportion of the device. In context, for example, with the coded patternshown in FIG. 7 and the scan image data of FIG. 9, a ridged feature (notshown in FIG. 7 or 9) in the coded pattern can further add anotherreference feature to align two images, thereby improving ease and speedof working with the scan image data. While a straight line is shown inFIG. 11, other embodiments can be used, such as a line havingpredetermined curvature or bends.

It is understood that the examples and embodiments described herein arefor illustrative purposes only and that various modifications or changesin light thereof may be suggested to persons skilled in the art and areincluded within the spirit and purview of this application and scope ofthe appended claims. Numerous different combinations of embodimentsdescribed herein are possible, and such combinations are considered partof the present invention. In addition, all features discussed inconnection with any one embodiment herein can be readily adapted for usein other embodiments herein. The use of different terms or referencenumerals for similar features in different embodiments does notnecessarily imply differences other than those which may be expresslyset forth. Accordingly, the present invention is intended to bedescribed solely by reference to the appended claims, and not limited tothe preferred embodiments disclosed herein.

What is claimed is:
 1. A method for digitally aligning a patient's teethwith a reference portion of the patient, the method comprising:acquiring, using a scanner, a first image of at least a portion of thepatient's teeth; positioning a device in a patient's mouth to align thedevice with a reference portion of the patient, the device comprising anocclusal portion and a non-occlusal portion, the occlusal portioncomprising a bite plate held between the patient's teeth so as to securethe device in a position during a scanning procedure and thenon-occlusal portion comprising a coded pattern for aligning scannedimages of the patient, the occlusal portion and the non-occlusal portionbeing coupled together at an angle such that the coded pattern isoutwardly oriented from the patient's mouth when the bite plate ispositioned between the patient's teeth, so that the coded pattern ispresented to permit scanning of the coded pattern simultaneously whenscanning at least the portion of the patient's teeth; acquiring, usingthe scanner, a second image of at least a portion of the coded patternand at least the portion of the patient's teeth: and processing thefirst image and the second image to determine a spatial relationshipbetween at least the portion of the patient's teeth and the referenceportion by calculating a first spatial relationship between at least theportion of the coded pattern and at least the portion of the patient'steeth and the alignment between the device and the reference portion. 2.The method of claim 1, further comprising a lip displacement attachmentconfigured to move a lip of the patient so as to expose at least some ofthe patient's teeth and allow scanning of the coded pattern in relationto at least some of the patient's teeth.
 3. The method of claim 1,wherein the coded pattern comprises a plurality of bars oriented in thecoded pattern at predetermined distances from each other, intersectingat predetermined angles, or both.
 4. The method of claim 1, wherein thecoded pattern comprises at least one portion that comprises a lengthwiseportion forming a reference line for aligning images acquired during thescanning procedure.
 5. The method of claim 1, wherein the device furthercomprises at least one extension portion capable of being aligned withthe reference portion, the reference portion comprising the sagittalplane of the patient, a plane orthogonal to the sagittal plane, or both.6. The method of claim 1, wherein the reference portion comprises thepatient's temporomandibular joint.
 7. The method of claim 1, wherein thescanner is an optical scanner.
 8. The method of claim 7, wherein theoptical scanner comprises confocal optics.
 9. A system for digitallyaligning a patient's teeth with a reference portion of the patient, thesystem comprising: a device comprising an occlusal portion and anon-occlusal portion, the occlusal portion comprising a bite plate forsecuring the device positioned in a patient's mouth during a scanningprocedure and the non-occlusal portion comprising a coded pattern foraligning scanned images of the patient, the occlusal portion and thenon-occlusal portion being coupled together at an angle such that thecoded pattern is outwardly oriented from the patient's mouth when thebite plate is positioned between the patient's teeth, so that the codedpattern is presented to permit scanning of the coded patternsimultaneously when scanning at least a portion of the patient's teeth,the device further comprising at least one extension portion capable ofbeing aligned with the reference portion; a scanner for acquiring afirst image of at least the portion of the patient's teeth and a secondimage of the coded pattern and at least the portion of the patient'steeth; and a computer comprising storage media comprising instructionsthat, when executed, cause the computer to determine a spatialrelationship between at least some of the patient's teeth and thereference portion associated with the patient by calculating a firstspatial relationship between the device and at least the portion of thepatient's teeth and a second spatial relationship between the device andthe reference portion.
 10. The system of claim 9, further comprising alip displacement attachment configured to move a lip of the patient soas to expose at least some of the patient's teeth and allow scanning ofthe coded pattern in relation to at least some of the patient's teeth.11. The system of claim 9, wherein the coded pattern comprises aplurality of bars oriented in the coded pattern at predetermineddistances from each other, intersecting at predetermined angles, orboth.
 12. The system of claim 9, wherein the coded pattern comprises atleast one portion that comprises a lengthwise portion forming areference line for aligning images acquired during the scanningprocedure.
 13. The system of claim 9, wherein the reference portioncomprises the sagittal plane of the patient, a plane orthogonal to thesagittal plane, or both.
 14. The system of claim 9, wherein the scanneris an optical scanner.
 15. The system of claim 14, wherein the opticalscanner comprises confocal optics.